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Organization
BOULWARE MISSION INC
Active
Organization
BOULWARE MISSION INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHANE SHERIFF LCADC, LPCC, CCS (CLINICAL DIRECTOR)
(270) 683-8267
Entity
Organization
Contact information
Practice address
609 WING AVE, OWENSBORO, KY 42303-0408
(270) 683-8267
Mailing address
609 WING AVE, OWENSBORO, KY 42303-0408
(270) 683-8267
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/13/2026
Last updated
07/13/2026
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